what do trainee health researchers think about the future of medical research in Canada? Does anyone in the government care?
A recent report from the Canadian Institutes of Health Research (CIHR) Trainee Brainstorming Session, Visions of the Future: Health Researchers of Tomorrow Speak Out , may shed some light on these questions.
In January 2002, 27 Canadian research trainees from across North America assembled at Hôtel Le Chantecler Resort and Convention Centre in Sainte-Adêle, Québec, for the first Trainee Brainstorming Session hosted by the CIHR. Kelly Van Koughnet, director of Research Planning and Resourcing at the CIHR, was a key organiser of the meeting. "I wanted CIHR to develop a more robust relationship with Canadian health research trainees and to devote some time and resources to making this a systematic part of what CIHR was about," she tells Next Wave Canada.
The group of trainees comprised master's, PhD, and MD/PhD students, as well as postdoctoral fellows and clinician scientists in training in areas as diverse as basic and clinical research, health policy, and public health. The delegates expressed their thoughts on several areas of concern to CIHR, including:
The presumed strengths and weaknesses of the Canadian training experience
How CIHR could best contribute to trainee career development
How CIHR could utilise the skills of this oft-overlooked talent pool to develop its strategic thinking, policies, and knowledge translation.
What emerged from the discussion were a number of hotly debated topics of importance to the trainees, as addressed by CIHR Graduate Science Writer Scholarship holder Lindsay Borthwick in a report  of the sessions released in September. A few of the report's main points of discussion are summarised in this article, and in addition, Next Wave Canada spoke with three members of the delegation to get their opinion of the meeting and what might come of it.
National Quality Standards
Among the hardest to control facets that influence the overall quality of a given training environment are the quality of supervision and the quality of the training program itself. The innovative idea of national quality standards for trainees--a trainee 'Bill of Rights'--was thus put forward as a way in which CIHR, in partnership with other funding agencies and universities, could both encourage and support a more uniform training environment. The proposed Bill of Rights would focus first on developing a database of trainees and creating a council to effect, and monitor, changes to the primary areas of funding, training, and supervision.
"This idea was born out of discussions between the different trainees in which it became clear that the standards and training format differs widely among different institutions," explains Alison Kydd, a MD/PhD student at the University of Calgary and a delegate to the brainstorming session. "CIHR, as a federal funding agency, is in a great position to encourage the creation of national standards for the training experience and thereby impact the quality of training for all trainees," says Kydd.
The postdoc contingent at the meeting was particularly supportive of the idea of national standards. Even though some progress  has been made in establishing postdoctoral guidelines at individual Canadian universities, postdocs continue to be concerned about the disparities between universities in both employment conditions and the level of funding postdocs receive. The delegates want the funding agencies to push harder to ensure that national standards in both are put in place at all institutions.
Not surprisingly, funding came up as a key issue in the brainstorming session. Delegates agreed that health research in general is seriously underfunded in Canada and that trainee stipends in particular are too low. For example, CIHR currently funds about 30% of applicants to the Doctoral Research Awards (DRA) program. Although the DRA trainees felt that this was an acceptable cut-off level, they argued that the average value of a DRA should be increased from the existing stipend of CA$19,030 per year for 3 years and even extended to 4 years. Brainstorming delegates also proposed the controversial idea of indexing the awards to the cost of living and tuition levels in particular cities or universities and reviewing those levels on an annual basis.
The delegates also emphasised the need for funding support that covers each of the stages of research training--for example, they advocated the creation of awards for summer training of undergraduates. And they proposed that the CIHR create a Master's Research Award to recognise and support the vast amount of quality research being conducted at that level. However, brainstorming delegate Heather Wilson, currently a postdoc at the University of Saskatchewan, disagrees with that idea. "I think that students at the master's level have made no commitment yet as to whether they will pursue a career in research or whether they will take other avenues", says Wilson. The delegates would also like to see CIHR make available a separate pool of funds specifically to ease the transition from postdoc to junior faculty positions.
As Next Wave readers are well aware, there is typically a huge void in career counselling at the university level in Canada. So, during the meeting, the delegates combined their efforts and put together a wish list (see box) for improved exposure to information about careers in and out of academia.
Some delegates felt that a transdisciplinary approach to health research in Canada should be encouraged and facilitated. Jeff Fillingham, a PhD student at York University, sees a role for CIHR to encourage more trainees to become clinician scientists, by creating funding for academic PhD's to enter medical school with the intention of becoming clinical scientists. "I would love to see a program to bridge academic and clinical science," he says, "I think this is a real 21st century issue."
More Than Just Talk
According to the report, the delegates brought tremendous energy, insight, and a wealth of ideas to the meeting. And it was a great opportunity for delegates to network. "I found it really enjoyable to meet such a diverse group of people from across North America," says Kydd. In addition to an afternoon of social activities like skiing, Wilson felt that the meeting provided an opportunity to "get a feel for the mood of postdoctoral fellows and graduate students across the country."
Not only that, it was a rare opportunity for trainees to speak their minds, given that their views are rarely sought or heard at the government or federal funding agency level. Kydd applauds the CIHR's wisdom in soliciting from the next generation of researchers their ideas for building a stronger training environment in the country. "I feel that by consulting with trainees, the CIHR is making important steps in both improving the continuity of training and raising the national and international profile of Canada's very successful research community, both present and future," she tells Next Wave Canada.
Participants of the brainstorming session certainly hope that the report will serve as a platform for future discussion and action on strategies and priorities. "The CIHR appear to be showing a real commitment to training issues," says Fillingham, "They appear to be genuinely interested in change."
With the packaging of the report completed, CIHR is now focussing on marketing of the consultation to target audiences. "We are delivering a hard copy of this report to each of research teams that are now mounting CIHR-funded Strategic Training Initiatives in Health Research ", says Van Koughnet. "As these teams develop their training programs, we think this direct advice from an engaged group of trainees is a valuable commodity."
Van Koughnet is keen to ensure that the report doesn't fall on "overloaded" ears within CIHR because, in her mind at least, what trainees think does matter. "I certainly hope that this is only the beginning of a trend where trainees are brought into more and more of our strategic conversations." She says that CIHR is planning to run similar workshops every 2 years, although future events will likely have a more targeted focus for discussion. "From where I'm sitting, the most significant achievement of this initiative was to raise the profile of trainees within CIHR itself and establish them as a not only legitimate but essential stakeholder in all of CIHR's activities."
But beyond distributing the report, it remains to be seen whether inaction on the part of the funding agency relegates the event to that of a "talking shop." "As of now, it is really just a list of trainee issues," says Fillingham, who continues: "What does the CIHR think? How will they respond?"